Miranda Wade

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT010515 Issued in GA

Practice address

3540 Wheeler Rd Ste 314
Augusta, GA 30909-1885

Phone

(478) 206-7146

NPI assigned

Feb 2, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1780447680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5326",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309165326",
            "telephone_number": "478-206-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 WHEELER RD STE 314",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091885",
            "telephone_number": "478-206-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MIRANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT010515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Vranicar, MD
• Vinh Tu Vuong
• Rohan Vuppala
• Srinivasareddy Vuyyuru, MD
• W S Flanagin Jr Inc (Hill Drug Company)
• Robert Tyson Wade, MS.
• Kristen Waghorn, MS, CCC-SLP
• Kathryn Ann Wagner, DPT
• Keith Aloysius Wagner, PHARMD
• Deborah P. Wakefield, LCSW

• Massage Therapist in Augusta, GA
• Providers in Augusta, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.